Basic Information
Provider Information
NPI: 1972855930
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROWE
FirstName: LORELEI
MiddleName: SIMPSON
NamePrefix:  
NameSuffix:  
Credential: PH.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SIMPSON
OtherFirstName: LORELEI
OtherMiddleName: ELIZABETH
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: PH.D.
OtherLastNameType: 1
Mailing Information
Address1: 4 ALLEGHENY CTR FL 8
Address2:  
City: PITTSBURGH
State: PA
PostalCode: 152125255
CountryCode: US
TelephoneNumber: 4123304000
FaxNumber:  
Practice Location
Address1: 4 ALLEGHENY CTR FL 8
Address2:  
City: PITTSBURGH
State: PA
PostalCode: 152125255
CountryCode: US
TelephoneNumber: 4123304000
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/15/2012
LastUpdateDate: 10/22/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/22/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103T00000X36261TXN Behavioral Health & Social Service ProvidersPsychologist 
103TC0700XPS018513PAY Behavioral Health & Social Service ProvidersPsychologistClinical

No ID Information.


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